For roughly 500 families, the key uncertainty is where they will receive prenatal, postnatal and delivery care after Yakima Valley Farm Workers Clinic ends those services at its Woodburn and Salem clinics in February. The clinic is laying off eight primary care physicians who also provided some obstetric care and replacing them with eight full-time primary care providers who will not deliver babies, according to The Lund Report.
According to The Lund Report, the clinic is ending prenatal, postnatal and delivery care at its Salud Medical Clinic in Woodburn and its Lancaster Family Health clinics in Salem in February. The replacement providers will include at least three physicians along with physician associates and nurse practitioners, none of whom will provide obstetric care, Yakima Valley Farm Workers Clinic CEO Christy Trotter said. The organization has given its current staff physicians 120-day notices, and the Salud Medical Center's own location page still lists family medicine and obstetrics among its services.
When the eight doctors received notices in mid-October, the clinic had no formal agreements with other local providers to ensure obstetric access, The Lund Report reported. No agreements had been reached by the time of that report. Trotter said she expected to finalize written agreements with Legacy Health by February, when the change takes effect. Until then, the clinic plans to refer patients needing obstetric care to Legacy Silverton Medical Center or providers of their choice. A Yakima spokesperson told the outlet the goal is to establish a clear plan for each patient's continuing care.
A System Built for Farmworkers Since 1978
Yakima Valley Farm Workers Clinic began in 1978 with federal funding to provide health care for seasonal workers in the Yakima Valley, and it has since grown into a system of about 50 clinics spread across northwest Oregon and southern Washington with a budget of nearly $400 million, serving more than 200,000 people each year. It is the second-largest federally qualified health center network in the Pacific Northwest and the 18th-largest in the United States, the outlet reports. In Marion County, the clinics served lower-income pregnant women, many of whom were immigrants and seasonal workers, in a setting where Spanish-speaking providers and staff made immigration status a non-issue for patients who are mostly Hispanic or Latino, living in poverty, and often in rural areas.
The clinic is laying off physicians who provided primary care and some obstetric care. Legacy Health offered positions to all of the terminated providers, including some at Silverton Hospital, and said it was exploring ways to support continuity for patients and providers. Trotter told the outlet that patients may retain some continuity if their providers stay in the area and work at Silverton.
Numbers Larger Than Recent Hospital Closures
Yakima estimates that about 500 families will be affected by the obstetric cuts, more than the combined number of patients impacted by three recent hospital birthing-center closures in Baker City, Seaside and Ashland since 2023, according to figures cited by The Lund Report. Clinic providers currently deliver between 400 and 500 babies each year at Legacy Silverton Hospital. The outlet also reported Kevin Heidrick's assessment that ending the services will have a huge impact on Woodburn and Latino communities, and Page Griffin Jossi's concern that Woodburn and Salem lack enough obstetric capacity to absorb all the affected patients.
Reyna Lopez Osuna, executive director of PCUN, the Northwest Treeplanters and Farmworkers Union, said farmworker families should not have to worry about where they will receive prenatal and postpartum care. The clinic is replacing the physicians with primary-care providers, even as Trotter acknowledged the organization has struggled to meet regional primary care needs and that primary care access will remain challenging with provider shortages persisting. Griffin Jossi expressed concern that Woodburn and Salem lack enough obstetric capacity to absorb all the affected patients.
Who Is Responsible for Backfilling Care
The responsibility for arranging replacement care remains unsettled. The Lund Report noted that hospitals and health systems are not legally required to accept patients for non-emergency or outpatient care. PacifiSource, paid by the Oregon Health Authority to coordinate the Marion-Polk Coordinated Care Organization, is contractually obligated to ensure adequate capacity for regional needs. The report also describes Yakima Valley Farm Workers Clinic's legal duty to provide primary and preventive care to underserved populations regardless of immigration status or ability to pay, and says the organization is obligated to provide obstetric care. Trotter said obstetric care at the Woodburn and Salem clinics will end.
Federal guidance calls on clinics cutting a service to seek permission and provide written agreements with other providers to ensure adequate care, according to The Lund Report. Trotter said federal permission was not necessary because Yakima continues to provide some obstetric care at other clinics in its two-state system. Separately, a Health Resources and Services Administration compliance FAQ describes an arrangement in which a referral provider delivers obstetrical services to health center patients and applies a nominal charge to those at or below the federal poverty line. The agency did not respond to the outlet's request for comment on how that guidance applies here. Dawn Mautner and Emma Sandoe also did not immediately respond to a request for comment, the outlet reported.
Part of a Wider Pattern of Maternity Care Losses
The Woodburn and Salem cuts land amid broader strain on Oregon's maternity care system. March of Dimes PeriStats classifies 11.1% of Oregon counties as maternity care deserts.
Those pressures have already played out at individual hospitals. Providence closed the inpatient maternity unit at its Seaside hospital effective October 4, 2025, citing a falling birthrate in Clatsop County and a shortage of skilled physicians and nurses, as OPB reported; the cuts there also eliminated well-newborn inpatient care and surgical gynecologic care. A Chartis report cited by OPB found more than a quarter of rural hospitals nationwide have eliminated obstetrics services since 2011, and Providence Seaside's own births fell from 109 in 2014 to 51 last year. Asante similarly planned to end inpatient care and close the birth center at Ashland Community Hospital by spring as it converts that facility into a satellite campus of Rogue Regional Medical Center, OPB reported.
Listed services do not confirm available capacity
For patients seeking alternatives, Salem Health lists prenatal care, labor and delivery, and postpartum care among its OB/GYN services. That listing does not establish whether Salem Health can accept patients affected by Yakima's change; Yakima has said it plans to refer patients to Legacy Silverton Medical Center or providers of their choice. The changes also differ from a recent hospital-unit closure. KOIN reported on Aug. 19, 2025, that Providence Seaside Hospital would stop offering labor and delivery and related services starting Oct. 4. That was a hospital-service closure, unlike Yakima's planned end to clinic-based obstetric care.
